Tag: trial
Association Between Fluid Balance and Outcomes in Critically Ill Children
Fluid overload is common and is associated with substantial morbidity and mortality in critically ill children. Additional research should now ideally focus on interventions aimed to mitigate the potential for harm associated... read more
The ADRENAL Trial: Steroids in Septic Shock
Randomized clinical trials evaluating the efficacy of adjunctive corticosteroids in septic shock have shown conflicting evidence of clinical relevance. Two trials in particular looked at lower dose hydrocortisone (200mg/day)... read more
Barriers and Facilitators to Early Rehabilitation in Mechanically Ventilated Patients
Using a theoretically driven approach, this study identified important barriers and facilitators to early rehabilitation in ICU patients. In particular, the domains of social influences and behavioral regulation were not... read more
Supplemental Parenteral Nutrition vs. Usual Care in Critically Ill Adults
This individually titrated supplemental PN strategy applied over 7 days significantly increased energy delivery when compared to usual care delivery. Clinical and functional outcomes were similar between the two patient groups.... read more
Glycaemic Control Targets After TBI
This meta-analysis of intensive glycaemic control shows no association with reduced mortality in TBI. Intensive glucose control showed a borderline significant reduction in the risk of poor neurological outcome, but markedly... read more
Comparison between a nurse-led weaning protocol and weaning based on physician’s clinical judgment in tracheostomized critically ill patients
In this pilot RCT we demonstrated that a nurse-led weaning protocol from tracheostomy was feasible and safe. A larger RCT is justified to assess efficacy. We enrolled 65 patients, 27 were in the protocol group and 38 in the... read more
Predictors of Intubation in Patients With AHRF Treated With a Noninvasive Oxygenation Strategy
In patients with acute hypoxemic respiratory failure breathing spontaneously, the respiratory rate was a predictor of intubation under standard oxygen, but not under high-flow nasal cannula oxygen or noninvasive ventilation.... read more
Dexmedetomidine Prevents AKI After Adult Cardiac Surgery
Perioperative administration of dexmedetomidine in adult patients undergoing cardiac surgery may reduce the incidence of postoperative AKI. Future trials are needed to determine the dose and timing of dexmedetomidine in improving... read more
An Interprofessional Quality Improvement Initiative to Standardize Pediatric Extubation Readiness Assessment
An interprofessionally developed respiratory therapist–led extubation readiness protocol can be successfully implemented in a busy tertiary care PICU without adverse events. We analyzed data from 398 mechanically ventilated... read more
The Case of the Relative Insufficiency
When it comes to the efficacy of glucocorticoid therapy for the treatment of septic shock, we have existed in a state of ambiguity, torn between the results of two contradictory RCTs. The first, the Annane et al trial published... read more
Pooled analysis of higher versus lower blood pressure targets for vasopressor therapy septic and vasodilatory shock
Targeting higher blood pressure targets may increase mortality in patients who have been treated with vasopressors for more than 6 h. Lower blood pressure targets were not associated with patient‑important adverse events... read more
Hypothermia in Sepsis – The CASS Trial
Sepsis and especially septic shock (no matter what definition you use) is a recipe for multi-organ dysfunction and poor prognosis. In the past few years, we saw a lot of failed attempts trying to find something that could... read more
High Frequency Percussive Ventilation Increases Alveolar Recruitment in Early ARDS
High frequency percussive ventilation (HFPV) combines diffusive (high frequency mini-bursts) and convective ventilation patterns. Benefits include enhanced oxygenation and hemodynamics, and alveolar recruitment, while providing... read more
Rivaroxaban Lowers Cardiovascular Risk But Increases Bleeding Risk
In 27,395 patients with stable atherosclerotic disease, the addition of 2.5 mg rivaroxaban twice daily to aspirin therapy reduced the rates of cardiovascular death, stroke, or nonfatal MI, at the cost of increased major bleeding... read more
Helping The ITU Patient Sleep
It is well-known that patients in the intensive care units do suffer from a lack of sleep and frequent sleep disturbances. So how can we help the ITU patient sleep? This is a Cochrane review looking at the efficacy of non-pharmacological... read more
Chloride and Other Electrolyte Concentrations in Commonly Available 5% Albumin Products
This study is the first to identify and document a statistically significant variability in the chloride concentration of available 5% albumin products. This study has also informed a pilot randomized controlled trial examining... read more
Age of Red Cells for Transfusion and Outcomes in Critically Ill Adults
The age of transfused red cells did not affect 90-day mortality among critically ill adults. In an international, multicenter, randomized, double-blind trial, we assigned critically ill adults to receive either the freshest... read more
Enhancing Recovery From Sepsis
Survival from sepsis has improved in recent years, resulting in an increasing number of patients who have survived sepsis treatment. Current sepsis guidelines do not provide guidance on posthospital care or recovery. In the... read more
Central Venous Catheter – Which Needle?
A prospective randomised trial comparing insertion success rate and incidence of catheterisation-related complications for subclavian venous catheterisation using a thin-walled introducer needle or a catheter-over-needle... read more
Effect of Standardized Handoff Curriculum on Improved Clinician Preparedness in the ICU
The UW-IPASS standardized handoff curriculum was perceived to improve intensive care provider preparedness and workflow. IPASS-based curricula represent an important step forward in communication standardization efforts and... read more
Effect of Individualized vs Standard Blood Pressure Management Strategies on Postoperative Organ Dysfunction
Effect of Individualized vs Standard Blood Pressure Management Strategies on Postoperative Organ Dysfunction Among High-Risk Patients Undergoing Major Surgery. Among patients predominantly undergoing abdominal surgery who... read more
Effect of Lung Recruitment and Titrated PEEP vs Low PEEP on Mortality in Patients with ARDS
In patients with moderate to severe Acute Respiratory Distress Syndrome (ARDS), a strategy with lung recruitment and titrated Positive End-Expiratory Pressure (PEEP) compared with low PEEP increased 28-day all-cause mortality.... read more
